Kevin M.

Roth, MD
Member of the American Academy of Orthopaedic Surgeons http://orthodoc.aaos.org/DrKevinRoth Advanced Sports Medicine, Hip Arthroscopy, Shoulder Reconstruction, and Fracture Care
Webster Orthopedics 3010 Colby Street Suite 118 Berkeley, CA 94705 USA Phone: 510.486.2300 | Fax: 510.486.2333

Fracture of the Shoulder Blade (Scapula)

Triangular, mobile, and protected by a complex system of surrounding muscles, the shoulder blade (scapula) is rarely broken. Scapula fractures represent less than 1% of all broken bones. High-energy, blunt trauma, such as that experienced in a motorcycle or motor vehicle collision or falling from significant height, can fracture the scapula and cause other major injuries, including broken ribs or damage to the head, lungs, or spinal cord.

Fracture patterns in the scapula

(Reproduced with permission from Zuckerman JD, Koval KJ, Cuomo F: Fractures of the scapula, in Heckman JD (ed): Instructional Course Lectures 42. Rosemont, IL, American Academy of Orthopaedic Surgeons, 1993, pp 271-281.)

Symptoms
Symptoms include: Extreme pain when you move the arm. Swelling around the back of the shoulder. Skin abrasions.
Without treatment, a fractured scapula can result in chronic shoulder pain and disability.

Diagnosis
To determine appropriate treatment, your doctor will probably need to take X-rays (radiographs) of your shoulder and chest to describe and classify the location(s) of fracture to the scapula. In some instances, your doctor may also need to use other diagnostic imaging tools such as computed tomography (CT). One or more parts of the scapula may be fractured: Scapular body (50% to 60% of patients) Scapular neck (25% of patients) Glenoid Acromion Coracoid Your doctor will evaluate the position and posture of the shoulder and treat any soft-tissue damage (abrasions, open wounds, and muscular trauma). Your doctor may want a detailed neurovascular examination, which may not be possible if you have other severe injuries.

Treatment
Nonsurgical treatment with a simple sling works for most fractures of the scapula. The immobilization device holds your shoulder in place while the bone heals. Your doctor may want you to start early range-of-motion exercises within the first week after the injury. Other fractures may need 2 to 4 weeks of immobilization. Your shoulder may feel stiff when the doctor removes the sling. Begin limited active use of your shoulder immediately. Passive stretching exercises should be continued until complete shoulder motion returns. This may take 6 months to 1 year. If you have an isolated scapular body fracture, your doctor may want you to stay in the hospital. Certain types of scapular fractures may need further evaluation: Fractures of the glenoid articular surface in which bone has moved out of place (displaced) significantly. Fractures of the neck of the scapula with severe angular deformity. Fractures of the acromion process with impingement syndrome. In these instances, you may need surgery in which the doctor uses plates and screws to hold the bone together.
Last reviewed: August 2007

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.
Copyright 2007 American Academy of Orthopaedic Surgeons

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